Noninvasive ventilation: a survey of practice patterns of its use in India

To understand the practice patterns of noninvasive ventilation (NIV) use by Indian physicians. Around three thousand physicians from all over India were mailed a questionnaire that could capture the practice patterns of NIV use. Completed responses were received from 648 physicians (21.6%). Majority (n = 469, 72.4%, age 40 +/- 9 years, M:F 409:60) use NIV in their clinical practice. NIV was most exclusively being used in the ICU setting (68.4%) and the commonest indication for its use was chronic obstructive pulmonary disease (COPD) (71.4%). A significant number did not report use of a conventional ventilator for NIV support (62%). Oronasal mask was the overwhelming favorite among the sampled physicians (68.2%). In most of the cases, the treating physician initiated NIV (60.8%) and a baseline blood gas analysis was performed in only 71.1% of the cases (315/443). Nasal bridge pressure sores was the commonest complication (64.2%). NIV is being widely used in clinical practice in India for various indications. COPD is the most common indication for its deployment. There seems to be a marked variability in the patterns relating to actual deployment of NIV, including the site of initiation, protocols for initiation followed, and monitoring of patients.